Form 5500 · Employee benefit plan · OGALLALA, NE
ASC CAPACITORS
The filing calls this plan AMERICAN SHIZUKI CORPORATION WELFARE BENEFIT PLAN.
ASC CAPACITORS of OGALLALA, NE is a 100-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is ACRISURE LLC DBA. Coverage is written through UNITED OF OMAHA LIFE INSURANCE COMPANY. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-2839225 · plan 501 · plan year 2024, filed May 8, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
The filing carries code 4S: this plan is filing again after previously being exempt.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
The filing discloses a single insured line, vision, through UNITED OF OMAHA LIFE INSURANCE COMPANY, covering 67 people.
The filing declares vision, health and dental. Health and dental appear with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $7,675, with $767 in disclosed broker commissions — about 10% of premium.
The most recent policy period ended in October, and the plan year ends October 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Vision | 67 | Nov 1, 2024 | $7,675 | $767 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Other plans filed by this employer
How this plan compares
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